Breast reconstruction is a branch of plastic surgery wherein the goal of surgery is to provide the patient with two balanced and symmetrical breasts. In this way, breast reconstruction is the rebuilding of a breast, usually in women. The process involves using autologous tissue or prosthetic material to construct a natural-looking breast and often this includes the reformation of a natural-looking areola and nipple. The procedure involves the use of implants or relocated flaps of the patient’s own tissue. Breast reconstruction is usually performed following a mastectomy, such as when the breast has been removed because of breast cancer. There are also occasional techniques of breast reconstruction which are used to treat women who have an abnormal development of one or both breasts.
There are two main methods by which a breast reconstruction is achieved surgically and that is through using breast implants or using living tissue. This living tissue is taken from a distant site on the same person and used to rebuild their breast, these includes the TRAM flap, Latissimus dorsi flap and other flaps as well.
Immediate Breast Reconstruction
Reconstruction that is performed at the time of mastectomy is termed as “immediate reconstruction”. This timely surgery has its advantages as well as its risks. The reconstruction meanwhile that is performed at any time afterwards mastectomy is termed “delayed reconstruction”. Some advantages of an immediate breast reconstruction is that the patient will wake up after cancer surgery with a new breast, or at the very least, the beginnings of a new one, already in place. Also, it may be more convenient since both surgical procedures, the mastectomy and the breast reconstruction, are performed at the same time, minimizing the number of surgical procedures as well as minimizing the number of recovery periods.
However, there are some disadvantages also of an immediate breast reconstruction which includes the fact that the patient must bare the strain and the possible risks of having two surgeries at just one full-blown instant. Also, there is no chance to adjust to the loss of the old breast before you get the new one and in turn, you must deal emotionally with cancer and with reconstruction at the same time. For the surgeon’s part, it may be difficult to coordinate two surgical services as general surgery and plastic surgery and to be able to be working at it the same time. Furthermore, the reconstruction may also interfere with any chemotherapy or radiation therapy that may be required after a mastectomy. For these reasons, it is wise to have a cancer treated first and then the reconstruction at a later time.
The nipple reconstruction is also part of the overall reconstruction. The timing of this procedure depends on several factors including surgeon and patient preference. However, usually it is performed at about 3 to 6 months post-reconstruction for this is a good time interval for everything to heal. The reconstructed breast is often swollen in the early postoperative period and another reconstruction might do a lot of harm. However, an Areola reconstruction can also be carried out at the time of the nipple reconstruction or later, depending on the technique used and surgeon preferences.
There are some advantages to a nipple and areola reconstruction and topping the list is that the reconstructed breast will match your natural breast more closely. Also, you can go braless if you want, and still have the shape of a nipple on both sides. However, the disadvantages of nipple and areola reconstruction can also be a lot.
For one, it is usually an additional operation that may require another general anaesthetic and another recovery period, although this time, it is much shorter. This procedure also produces new scars either at the nipple site or at a distant donor site and after all the trouble, the result is still that the new nipple will not have the same sensation as the opposite nipple. However, it is a safe procedure and any patient who has had a breast reconstruction may opt for a nipple and areola reconstruction as well. In general, there are also no contraindications to this procedure.
Inspite of the many things that Science can do, there are still many women who do not undergo a breast reconstruction. They’re reasons are because they may not be aware that it is available or they feel comfortable enough with just living with only one breast. Also, some women do not want to have more surgery than what’s necessary and their partners or families do not think reconstruction is necessary as well. There are also instances when there is no plastic surgeon who performs breast reconstruction in the immediate community. When this is the case, then a woman who chooses not to have a breast reconstruction can either live without any breast replacement or wear a prosthesis or a false breast.
Some women can brave living without any replacement of the breast. Wearing no replacement just makes things simpler, more convenient, and more comfortable. However, no replacement can also lead to some women feeling unbalanced with only one breast and realizing that it is harder to wear some kinds of clothes, like a bathing suit, with only one breast. Also, it may be harder to keep your posture straight because of the imbalance of just one breast.
That is why, a compromise between a surgery and not having a replacement is Breast Prostheses, a synthetic breast form that you can use under your clothing to recreate the breast. Some women actually use a prosthesis permanently because prostheses produce a more natural shape under clothes and produce a more “balanced” look. Also, prostheses do not require any additional surgery and even if the patient’s natural breast size changes like for example there are some changes in weight, then they can just adjust the size of their prosthesis.